Big Workflow Is Far-Wide-and-Near!

Let’s tackle Far-Wide-and-Near workflow first, because it’s the “Big” in Big Workflow. Events on the far side of Pluto can trigger events near, on, or even inside you, though I have trouble thinking of a use case for Pluto-to-implantable workflow. However, if you’re a NASA engineer, I can easily imaging a Pluto-to-wearable workflow. That’s the far and near. What about wide? Well, we humans care about a wide spectrum of different kinds of events, but they all potential contend with each other for our limited attention.

Big Workflow Is Familiar!

It’s easier to learn something new, if it resembles something old with which you are already familiar. Cognitive psychologists call this a “transfer” effect. Knowledge and competence in one domain is transferred to another domain, thereby reducing the time to master the second domain. The opposite is the “interference” effect. What you already know interferes with what you are trying to learn. The classic example of this in health IT is the degree with which EHR workflow resembles, or not, clinical workflow.

Big Workflow Is Fit!

Big workflow fits the job you are trying to accomplish. Do the workflows of the systems we attempt to master and manipulate fit the natural tasks and workflows of the jobs and goals we are attempting to accomplish? Fit and familiar are not the same though. We may attempt to master a completely new domain, one with which we are completely unfamiliar, yet the software application may naturally fit, or fail to naturally fit, the intrinisic tasks, goals, and workflows of that domain.

Big Workflow Is Foundational!

Big workflow is a foundation you can just count on being there. It allows to you build something else, on top. Software platforms are foundations on which we build applications. Applications that provide to use all the information we need, at each step of a workflow, are supportive, in this foundational sense.

Big Workflow Unfailing!

Big workflow is consistent. It never, ever, fails to be all of the other things in this list of Big Workflow ‘F’s. Big workflow is ALWAYS familar, it fits, is foundational, flexible, and far-near-and-wide. No, of course all workflows cannot ALWAYS be all these things. To be all of these things is an ideal, one which can never be completely achieve, yet it is ALWAYS to be striven for. It is the guiding star, from non-ideal workflows to ideal big workflows. Which brings us to…

Big Workflow Is Flexible!

How do we get to Big Workflow? Well, the workflow technology that makes workflow possible has to be flexible. If it is flexible, then we can change it. We can systematically improve even crappy workflow, to make it less crappy, then pretty good, and then, finally, eventually, as good as we can make it, given the time, money, attention, and resources available. Frankly, health IT has barely started along the path to Big Workflow, because the software technologies health IT relies are have relatively frozen workflows. Unless we adopt true workflow technology, one based on models of work and workflow, that are executable or at least mechanically consultable, health IT workflows won’t be sufficiently flexible to improve in the first place.

Healthcare Business Process Management

Now that we have so many databases full of clinical data everywhere, especially in EHRs (Electronic Health Records), we need to move from thinking about data to thinking about the workflows necessary to put all that data to work. We need to move from a Big Data mentality to a Big Workflow mentality.

We are seeing a wide variety of terminology applied to this space, from Care Coordination and Care Management Systems to Healthcare and Care Process Management. What all of these systems have in common is they are specifically designed and directed toward improved clinical task and workflow management. Many of these systems are leveraging Business Process Management (BPM) application platforms to build their software.

Let’s move from a data mentality to a workflow mentality. In doing so, we still create and use data, it’s just that we create and use data to accomplish valuable tasks, workflows, and goals. Big Workflow includes Big Data. But it’s bigger, like that wave of Big Workflow about to swamp that wave of Big Data.

Ebola & EHR Workflow Engines, Editors & Visibility

Robot-In-My-Pocket

Charles Webster, MD, MSIE, MSIS

Bio: HIMSS14, HIMSS15, and HIMSS16 Social Media Ambassador! If you've got a healthcare workflow story, I want to tell it, blog it, tweet it, interview you, etc.
Chuck Webster, MD, MSIE, MSIS has degrees in Accountancy, Industrial Engineering, Intelligent Systems, and Medicine (from the University of Chicago). He's the ex-CMIO for a three-time HIMSS Davies Award-winning pediatric EHR. Dr. Webster currently services as CMIMO (Chief Medical Informatics Marketing Officer) for workflow technology in healthcare. Chuck also created Mr. RIMP (@MrRIMP) (Robot-In-My-Pocket) a Bluetooth-controlled wearable robot for pediatricians and child life specialists to entertain children. Dr. Webster designed the first undergraduate program in medical informatics, was a software architect in a hospital MIS department, and is a judge for the annual Workflow Management Coalition Awards for Excellence in BPM and Workflow and Awards for Case Management. Chuck is a ceaseless evangelist for process-aware technologies in healthcare, including workflow management systems, Business Process Management, and dynamic and adaptive case management. Dr. Webster tweets from @wareFLO, @HealthITdog, and @MrRIMP (though there is some debate about the last two). He maintains almost a half-a-million words and graphics on numerous websites, including EHR Workflow Management Systems (http://chuckwebster.com), Healthcare Business Process Management (http://HCBPM.com) and the People and Organizations improving Healthcare with Health Information Technology (http://EHRworkflow.com). Please join with Chuck to spread the message: Viva la workflow!